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Julio V. Santiago, MD

JAMA. 1986;256(23):3263-3264.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

"Brittle diabetes" has been defined by Tattersall¹ as a condition in which the life of a person with diabetes is constantly disrupted by repeated episodes of hypoglycemia or hyperglycemia. Less than 5% of insulin-treated diabetic patients have this condition.^2,3 Although brittle diabetes can have many causes, the most common form involves an adolescent or young adult, most often female, who repeatedly does well under conventional treatment in the hospital but develops ketoacidosis at home. The majority of these patients have a serious behavioral, psychiatric, or social problem that interferes with appropriate treatment.^2,3 Although there are many causes for recurrent hospitalization for ketoacidosis, severe insulin resistance, and hypoglycemia,^4,5 the fact remains that few patients with insulindependent diabetes who adhere to a reasonable treatment plan that consists of two daily insulin injections and diet and blood glucose monitoring ever need in-hospital care for recurrent hyperglycemia or hypoglycemia. Indeed, . . . [Full Text PDF of this Article]

Author Affiliations
Washington University School of Medicine Children's Hospital St Louis

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